Syphilis laboratory findings: Difference between revisions
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*False-positive nontreponemal test results can be associated with various medical conditions unrelated to syphilis, including autoimmune conditions, older age, and injection-drug use;<ref name="pmid7548285">{{cite journal |author=Nandwani R, Evans DT |title=Are you sure it's syphilis? A review of false positive serology |journal=[[International Journal of STD & AIDS]] |volume=6 |issue=4 |pages=241–8 |year=1995 |pmid=7548285 |doi= |url= |accessdate=2012-02-16}}</ref> <ref name="urlwww.aphl.org">{{cite web |url=http://www.aphl.org/aphlprograms/infectious/std/Documents/LaboratoryGuidelinesTreponemapallidumMeetingReport.pdf |title=www.aphl.org |format= |work= |accessdate=2012-12-19}}</ref> therefore, persons with a reactive nontreponemal test should receive a treponemal test to confirm the diagnosis of syphilis. | *False-positive nontreponemal test results can be associated with various medical conditions unrelated to syphilis, including autoimmune conditions, older age, and injection-drug use;<ref name="pmid7548285">{{cite journal |author=Nandwani R, Evans DT |title=Are you sure it's syphilis? A review of false positive serology |journal=[[International Journal of STD & AIDS]] |volume=6 |issue=4 |pages=241–8 |year=1995 |pmid=7548285 |doi= |url= |accessdate=2012-02-16}}</ref> <ref name="urlwww.aphl.org">{{cite web |url=http://www.aphl.org/aphlprograms/infectious/std/Documents/LaboratoryGuidelinesTreponemapallidumMeetingReport.pdf |title=www.aphl.org |format= |work= |accessdate=2012-12-19}}</ref> therefore, persons with a reactive nontreponemal test should receive a treponemal test to confirm the diagnosis of syphilis. | ||
===Nontreponemal test=== | |||
*Includes VDRL and RPR tests | |||
*Antibody titers may correlate with disease activity | |||
*May reverse following treatment | |||
*Used to follow treatment response | |||
*A fourfold change in titer is necessary to demonstrate significant difference between two nontreponemal tests | |||
*Results from two tests cannot be compared directly with eachother | |||
* | ===Trepenomal tests === | ||
*Include | |||
*Antibody titres once positive remains positive for the rest of life regardless of treatment or disease activity | |||
*cannot be used for monitoring treatment response | |||
*Screening using trepenomal tests may help identify individuals previously treated for syphilis, those with untreated or incompletely treated syphilis, and persons with false-positive results | |||
==References== | ==References== | ||
Revision as of 14:51, 28 September 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
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Overview
Darkfield examinations and tests to detect T. pallidum in lesion exudate or tissue are the definitive methods for diagnosing early syphilis.
Laboratory Findings
- Darkfield examinations and tests to detect T. pallidum in lesion exudate or tissue are the definitive methods for diagnosing early syphilis.
- Although no T. pallidum detection tests are commercially available, some laboratories provide locally developed PCR tests for the detection of T. pallidum.
- A presumptive diagnosis of syphilis is possible with the use of two types of serologic tests:
- Nontreponemal tests (e.g., venereal disease research laboratory (VDRL) and rapid plasma reagent test) and
- Treponemal tests (e.g., fluorescent treponemal antibody absorbed (FTA-ABS) tests, the T. pallidum passive particle agglutination (TP-PA) assay, various enzyme immunoassays, and chemiluminescence immunoassays).
- The use of only one type of serologic test is insufficient for diagnosis, because each type of test has limitations, including the possibility of false-positive test results in persons without syphilis.
- False-positive nontreponemal test results can be associated with various medical conditions unrelated to syphilis, including autoimmune conditions, older age, and injection-drug use;[1] [2] therefore, persons with a reactive nontreponemal test should receive a treponemal test to confirm the diagnosis of syphilis.
Nontreponemal test
- Includes VDRL and RPR tests
- Antibody titers may correlate with disease activity
- May reverse following treatment
- Used to follow treatment response
- A fourfold change in titer is necessary to demonstrate significant difference between two nontreponemal tests
- Results from two tests cannot be compared directly with eachother
Trepenomal tests
- Include
- Antibody titres once positive remains positive for the rest of life regardless of treatment or disease activity
- cannot be used for monitoring treatment response
- Screening using trepenomal tests may help identify individuals previously treated for syphilis, those with untreated or incompletely treated syphilis, and persons with false-positive results
References
- ↑ Nandwani R, Evans DT (1995). "Are you sure it's syphilis? A review of false positive serology". International Journal of STD & AIDS. 6 (4): 241–8. PMID 7548285.
|access-date=requires|url=(help) - ↑ "www.aphl.org" (PDF). Retrieved 2012-12-19.